Lawrence W Gordon, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

19749 Issued in TN

Practice address

6005 Park Ave
Ste 624B
Memphis, TN 38119-5221

Phone

(901) 682-1100

Fax

(901) 682-6915

NPI assigned

Jun 17, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in AR, TN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Ophthalmology

Education

University of Tennessee, HSC, College of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mid South Retina Associates, LLCGroup PAC ID 8921080094, shared by 3 NPIs, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lgordon@msra.intellechartdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mid South Retina Associates, LLC

  • Ophthalmology Physician
  • Jackson, TN
  • NPI 1447286802
  Medicare reassignment NPD
• Mid South Retina Associates, LLC

  • Ophthalmology Physician
  • Blytheville, AR
  • NPI 1316973076
  Medicare reassignment NPD
• Mid-South Retina Associates, LLC

  • Ophthalmology Physician
  • Memphis, TN
  • NPI 1215963350
  NPD
• Mid South Retina Associates LLC

  • Ophthalmology Physician
  • Corinth, MS
  • NPI 1598700254
  NPD
• Mid-South Retina Associates, LLC

  • Ophthalmology Physician
  • Dyersburg, TN
  • NPI 1689600215
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jackson Madison County General Hospital

  • General Acute Care Hospital
  • Jackson, TN
  • NPI 1093705428
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493164800000",
    "number": "1982609665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000 DEPT 448",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381480448",
            "telephone_number": "901-682-1100",
            "fax_number": "901-682-6915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 PARK AVE",
            "address_2": "STE 624B",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195221",
            "telephone_number": "901-682-1100",
            "fax_number": "901-682-6915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "LAWRENCE",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2017-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "19749",
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "TN",
            "license": "19749",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146871001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS MEDICARE",
            "identifier": "5L961",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0119321",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF ARKANSAS",
            "identifier": "5L961",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3050718",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180031674",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF TENNESSEE",
            "identifier": "3066300",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00777025",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kunj Arun Gor, MBBS
• Vijaya Kumar Gorantla, M.D
• Gordon Heart Clinic PC
• Jason L Gordon, MPH, RDN, LDN, CHES
• Jerlena T. Gordon, APRN-BC
• Leslie R Gordon, D.D.S.
• Steven Gordon, DPT
• Tara Gordon
• Aaliyah Monnay Gore
• Christopher Stephen Gore

• Ophthalmology Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Ophthalmology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.